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PACCO COUNTY, FLORIDA <br /> Permit No. <br /> f Date Permitted 2 <br /> Builder Name/Owner Name Cri Control#' ' <br /> County Parcel No. 26-2_)_Z52_10­6b0X- _5 // SubDiv: <br /> Address/Location -7 � +� b- <br /> ;' �u)i�CiassifEcation/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: (=h-- <br /> ;:'.;. s: , Exempt '❑Yes ❑ No How Determined <br /> Impact Fee Amount $.r (� Zone No. TAZ: <br /> t SCHOOL IMPACT FEE <br /> Account (0561 Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> t'..x (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [(]Yes ❑No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit -Recreation Total / <br /> Zone TOTAL AMOUNT $ fib <br /> t <br /> Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> ' Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> Ili 4. <br /> 'a Acknowledgement below does not imply acceptance of concurrence,but simply receipt of a copy of this form,placing <br /> the building permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY. <br /> Y, <br /> RECEIPT NO. DATE BY <br /> --- <br />